Provider Demographics
NPI:1407077043
Name:PATTON, HEATHER LINNAE (MS, CCC -SLP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:LINNAE
Last Name:PATTON
Suffix:
Gender:F
Credentials:MS, CCC -SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6169 HALL TOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061
Mailing Address - Country:US
Mailing Address - Phone:804-695-0943
Mailing Address - Fax:757-564-1683
Practice Address - Street 1:119 BULIFANTS BOULEVARD
Practice Address - Street 2:SUITE B
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188
Practice Address - Country:US
Practice Address - Phone:757-564-1650
Practice Address - Fax:757-564-1683
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist